My rights or your turf?

The Missouri State Medical Association has sued to keep midwifery illegal in Missouri. They challenge the constitutionality of the amendment that legalizes CPMs, claiming that midwifery is not related to the subject of the bill, which is health insurance. The medical association makes ludicrous claims about the meaning of the amendment, expounding about brick layers and abortions.

The amendment legalizes Certified Professional Midwives. It does this by overriding any other law disallowing people holding tocological (that means "birth-related") certification from an accredited organization. Only Certified Professional Midwives meet the criteria in the amendment. They are only legalized to practice according to their certification, which does NOT include (as MSMA claims) "c-sections, epidural anesthesia, and even terminations." The amendment does not legalize brick layers or professional golfers, as MSMA claims. They are spouting blatant falsehoods to turn people against this piece of legislation.

The amendment legalizing Certified Professional Midwives is not the ideal piece of legislation for anyone's purpose. Even midwifery advocates preferred a more straightforward bill, which regulates CPMs in much more detail. Such a bill was filibustered by the MSMA's pet Missouri Senator, Chuck Graham. The opponents refuse to negotiate or discuss reasonable legislation that will remove midwives from the category of felons. They will trample on my rights to protect their turf, their legally enforced monopoly on prenatal and birth care.

Midwives lack medical training

Here in Missouri, a bill passed the legislature with an amendment that will allow certified professional midwives (CPMs) to practice. The governor has stated that he intends to sign it. This issue is all over the news. The medical associations voice their objections, warning that midwives are not medically trained.

CPMs are not medically trained. Is this a lack of training, or an asset? These midwives are extensively trained in normal birth. Birth is not inherently a medical event. The first priority of the midwife's training is to know when the mother and baby could benefit from medical intervention. That's when she calls in the doctors and nurses. That's when medical training comes in handy. In the other 90% of births, the midwife does not lack any training. The absence of a medical background helps her support the mother through the birth process. Her extensive training helps her to prevent the birth from becoming a medical event, even as it reveals whether medical intervention will be beneficial.

Some people want to compare our birth results with countries who only have midwives as an option, no hospitals or doctors available. See how much better doctors are, they say! No one denies how fantastic the doctors and hospitals are when they're needed. They're essential for good outcomes in at least 1:20 births. But countries who have both options available, who use midwives for normal pregnancies and birth and call in obstetricians when they're needed, have the best birth outcomes of all!

I want to live in one of those countries. And I don't intend to move.

http://www.youtube.com/watch?v=SIRS-hez-qg

Birth outcomes

Yesterday I flipped through The Economist's "Pocket World in Figures 2007." It lists the highest and lowest infant mortality rates by country. The list lowest mortality rates lists the top 25 countries. The US doesn't make the list.

We spend more on maternity care than any other country in the world, by far. Why aren't we in the top 25 of infant survival rates? We are doing something wrong.